Global research on syndemics: a meta-knowledge analysis (2001-2020)

Abstract

Background: Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years. Methods: We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship. Results: We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science. Conclusions: The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.

Managing medical and psychiatric multimorbidity in older patients

“…173,174 Some commentators have framed race as a 'socially constructed proxy for structural determinants' 175 affecting health in many domains. This coincides with the rising academic interest in 'syndemics', 176 a public health concept exploring the overlapping influences leading to clustering of diseases in certain populations. First conceptualized by Merrill Singer in relation to the AIDS epidemic in the 1990s, 177 a syndemic was defined as a set of closely intertwined and mutual journals.sagepub.com/home/tpp…”

“…178 The list of social, structural, and contextual factors influencing ethnic and racial disparities include, but are not limited to: poverty, segregated housing, enslavement, colonialism, neocolonialism, systematic exclusion from opportunities, and unequal interaction with the healthcare system. 176 Rather than conceptualizing race and ethnicity as a 'risk factor', which runs the risk of classifying the issue as biologic, economic, or cultural and potentially places blame on individuals within a group, commentators have suggested looking at 'racism, not race' at intrapersonal, institutional, and structural levels. 175 Racial and ethnic discrimination exists in many forms, having been studied across many racial groups, 44,[179][180][181][182] in forms ranging from childhood racial discrimination, everyday discrimination, and major discriminatory events (i.e., infrequent incidents that require a significant shift or adjustment in one's life).…”

“… 178 The list of social, structural, and contextual factors influencing ethnic and racial disparities include, but are not limited to: poverty, segregated housing, enslavement, colonialism, neocolonialism, systematic exclusion from opportunities, and unequal interaction with the healthcare system. 176 …”

Factors affecting ability of TB patients to follow treatment guidelines – applying a capability approach

“…According to Mendenhall et al, a syndemic is a collection of epidemics brought on by unfavourable social and structural factors and these constitutive epidemics interact to cause excessive morbidity and death [ 24 ]. Hossain et al mentions syndemics as multimorbidity with intertwined biological, psychological, social, structural and other contextual factors that are in itself laced with inequity [ 25 , 26 ]. Syndemics are often characterised by systematic exclusion, policies that drive disproportionate wealth distribution and lack of access to resources, but have not gotten the attention they deserve.…”

Applying the syndemic framework to cancer research for effective cancer control in low- and middle-income countries

“…A review of the syndemic research highlights that studies of NCD-related syndemics tended to focus on micro-level context, pointing towards methodological gaps (such as a lack of mixed methods studies) and the challenges associated with interdisciplinary research. The meta-knowledge study of existing syndemic literature also highlights the need for studying this framework for the population in LMICs to inform evidence-based health policy-making that is inclusive and context-appropriate to advance global health for the most disadvantaged populations [ 16 , 17 ]. Effective research on syndemic problems thus requires taking methodological approaches that allow for the simultaneous exploration of diseases and their social contexts.…”